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Abstract
Background and Purpose: Infertility is a significant public health issue in Pakistan, with male factors contributing to a substantial proportion of cases. Semen analysis is a fundamental, cost-effective, and non-invasive diagnostic tool for assessing male infertility. This study aimed to evaluate the prevalence and seminal parameters of primary and secondary male infertility in Peshawar, Pakistan, and to raise awareness regarding its diagnosis and management.
Methodology: A cross-sectional study was conducted, involving 366 semen samples from infertile males. Samples were collected via masturbation, processed within one hour, and analyzed according to WHO guidelines. Sperm concentration, motility, morphology, and the presence of leukocytes were assessed. Bacterial culture was performed for samples with leukocytospermia.
Results: Primary infertility was observed in 264 (72.13%) patients, while 102 (27.86%) had secondary infertility. Among primary infertility cases, normospermia was found in 52 (14.20%), oligozoospermia in 106 (28.96%), oligoasthenozoospermia in 98 (26.77%), and azoospermia in 100 (27.32%). Among secondary infertility cases with leukocytospermia, normospermia was observed in 28 (27.45%), oligozoospermia in 48 (47.05%), oligoasthenozoospermia in 38 (37.25%), and azoospermia in 26 (25.49%). Bacterial growth was identified in 20 (19.60%) of leukocytospermic samples, predominantly Staphylococcus aureus (40%), Escherichia coli (30%), Streptococcus species (20%), and Proteus species (10%).
Conclusion: Semen analysis remains a valuable, accessible, and inexpensive test for diagnosing male infertility. In Peshawar, primary infertility is more prevalent than secondary infertility, with oligozoospermia and oligoasthenozoospermia being the most common abnormalities. Leukocytospermia is associated with significant semen parameter alterations and bacterial infections, underscoring the need for targeted diagnostic and therapeutic approaches.